Pregnant in Japan: Diet, Nutrition and Weight Gain

This is part 3 of the "Pregnant in Japan" series. The first two parts cover pregnancy resources and how to find a doctor, midwife or hospital in Japan.

Yes, there are some differences between Japan and western countries (and likely, many countries in general) in diet, nutrition and weight gain during pregnancy. I am mostly familiar with common standards in the US (from research), so feel free to share what may be different or the same in your home country. The information here is what I've found both online and in the pile of pamphlets and information the health center gave to us when we registered my pregnancy.

The topics covered in this post include:

Nutrition/Diet "Balance" Guide
Caloric Intake
Foods to Avoid
Fish to Avoid/Limit
Limit Salt
Weight Gain
Prenatal Supplements

Nutrition/Diet “Balance” Guide

This is based on Japan's basic nutrition guide (similar to the food pyramid in the US) with a few extra guidelines for the second and third trimesters.

On top is exercise and hydration (with water and tea). I thought tea was an interesting addition...

Next is grains (or literally “staples”): Daily recommendation is 5-7 servings, plus 1 in the third trimester. (I find it somewhat strange/amusing that all the grains are of the “white” variety and not whole grain...)

Vegetables (or literally “side dish”): Daily recommendation is 5-6 servings, plus 1 in the second and third trimesters.

Proteins (or literally “main dish”): Daily recommendation 3-5 servings, plus 1 in second and third trimesters.

Dairy: Daily recommendation is 2 servings, plus 1 in the third trimester.

Fruit: Daily recommendation is 2 servings, plus 1 in the second and third trimesters. (I also find it interesting that the fruit recommendation is one of the smallest categories, as opposed to the US).

You can also find the English version here.

Caloric Intake

How many extra calories a day does Japan recommend for each trimester? These numbers are added on to your normal caloric intake (which depends on your age and activity level) but may vary if your BMI is higher or lower than normal.

First trimester:         +50 calories
Second trimester:    +250 calories
Third trimester:        +450 calories
Breastfeeding:         +350 calories

I believe in the US, these numbers are about zero extra calories in the first trimester, 300 in the second, 450 in the third, and 200-500 for breastfeeding mothers. How does this stack up with your home country?

Foods to Avoid

These are probably similar to what your home country recommends (I know they are similar in the US anyway).

- Raw meat (note that it's meat, not fish)
- Unpasteurized foods (such as milk, cheese, etc. if it has not been pasteurized)
- Deli meats
- Smoked salmon

Fish to Avoid/Limit:

Yes, women eat sushi in Japan while pregnant. However, if you decide to go for it and satisfy that raw fish craving (I know I have had to at least a few times so far!), be careful where you eat - though most places in Japan are extremely careful about maintaining good, hygienic standards in terms of sushi preparation. My guess is that if they had a case of food poisoning they’d likely be out of business pretty fast...

That said, there is still the issue of mercury from seafood. By all means check the standards in your home country (I know the US recommends limiting tuna and other seafood with higher mercury levels), but as for Japan (recommended by the Ministry of Health, Labor and Welfare), recommendations are as follows:

Screenshot of translated advice for pregnant women of consumption of fish and mercury by the Ministry of Health, Labor and Welfare in Japan

I’ve not posted the English .pdf as it's dated 2005, but I compared with the more recently updated 2010 version in Japanese and this chart still appears to be the same. You can find the Japanese version here:

Limit salt

Most of the pamphlets and online information I’ve looked through recommend limiting salt, to prevent preclampsia. (Yes, I know there are other reasons and causes for this than salt - that's just what I've read).

Weight Gain

If your BMI is within the normal range (18.5 - 25) , then 7-12 kilograms (about 15-26 pounds) is the expected weight gain in Japan - though some doctors will be incredibly strict about this and push for the lower number (such as the doctor I saw in the beginning months... [link]). I’m not sure about other countries, but I believe in the US it is about 25-35 pounds (11-15 kg). Would love to hear from others what it’s like in other countries as well.

If your BMI is under 18.5,  9 - 12kg is the expected weight gain.

If your BMI is higher than 25, there isn’t an expected weight gain, but your doctor would likely talk to you about how much he or she thinks you should gain.

In the pamphlet I have for diet, it says to calculate your BMI by taking your pre-pregnancy weight in kilograms, and dividing it by your height in meters, then by your height in meters again. So for example, my pre-pregnancy weight was around 61kg, which I divide by 1.67m and by 1.67 again, which gives me something like 21.8. Of course, you can also find free BMI calculators all over the internet...

Prenatal Supplements

Doctors most likely won’t mention anything about supplements but some of the pamphlets and information you receive will, though they primarily emphasize eating a well-balanced diet and getting nutrients from the food you eat rather than relying on supplements. (Although, many of the things I’ve read from the US essentially say the same thing).

Some important words to know regarding supplements:

Supplement    サプリメント
Folic acid        葉酸
Calcium          カルシウム
Iron                 鉄

In the information I have for Japan, recommendations of specific minerals during pregnancy are as follows:

Iron:               20-22mg/day (varies depending on your age)
Calcium:        650mg/day
Folic acid:    .4mg/day

Where to find prenatal supplements in Japan

It seems that women who do use supplements may just take a regular multi-vitamin (or a specific vitamin/mineral supplement rather than a multi), but if you’re specifically looking for prenatal vitamins to use, try these places:

Akachan Honpo has a bunch of folic acid supplements in the form of candy, cookies, etc.

There are also a few options on Amazon Japan.

Some are folic acid “plus” supplements.

This one is folic acid and calcium “plus”.

I’ve also seen some prenatal supplements at my local daily goods store, so that’s another place to check.

Finally, iHerb is a good place to order from (in English) and one of my favorite online stores. (I have a first time order discount code if you'd like to use it [part of a rewards program]: ACI278 )

*Please note I am not a doctor or medical professional and the above are not personal recommendations or what you should do, but what Japan typically recommends for pregnant women. 

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